AFRO-NETS> RFI: HIV infection through sex (2)

[Eric Naterop <enaterop@unicef.org>]

RFI: HIV infection through sex (2)
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Dear Adamu Ayuba,

I am not surprised not seeing any conference responses to your re-
quest. Apparently there isn't a great deal of literature available on 
the transmission pathogenesis of HIV. I don't know of any studies 
based upon microbial isolation (and one knows why).

I came across a section on sexual transmission that contains some 
references. It's from an article written by V. Turner (also disre-
spectfully called an AIDS-dissident by the AIDS-establishment, but a 
different school of thought would be a better name). 

Success with your article.

Regards,
Eric Naterop
mailto:naterop@yahoo.com

--
I have copied this section full:

Sexual transmission of HIV

The Yin & Yang of HIV, Part 2 of 3, by V. Turner, Nexus Magazine, 
Volume 6, Number 5 (Aug-Sept 1999).

HIV/AIDS is claimed to be bi-directionally sexually transmitted. Data 
to support this claim are based not upon microbial isolation and con-
tact tracing, as is the orthodox practice for proving diseases are 
infectious and sexually transmitted, but on mostly retrospective 
studies of highly selected groups of individuals - including homosex-
ual and bisexual men, heterosexual men and women including prosti-
tutes - for antibodies in blood which react with certain proteins 
deemed "HIV-specific"


Homosexual men

In 1984, Gallo and his colleagues showed that "Of eight different 
sexual acts, a positive HIV antibody test correlated only with recep-
tive anal intercourse".[110] They also found that the more often a 
homosexual man had insertive anal intercourse, the less likely he was 
to become HIV-positive. This is incompatible with an infectious 
cause. In 1986, Gallo and his colleagues reported they "found no evi-
dence that other forms of sexual activity contribute to the risk" of 
HIV seroconversion in homosexual men.[111] In an extensive review of 
25 studies of homosexual men reported in 1994 by Caceres and van 
Griensven, the authors concluded that "no or no consistent risk of 
the acquisition of HIV-1 infection has been reported regarding inser-
tive intercourse".[112] In the West, the largest and most judiciously 
conducted prospective epidemiological studies, such as the Multicen-
ter AIDS Cohort Study (MACS) of 4,954 gay men,[113] have proven be-
yond all reasonable doubt that in homosexual men the only significant 
sexual act related to becoming HIV-antibody-positive is receptive 
anal intercourse. Thus, in gay men, AIDS may be likened to the non-
infectious condition, pregnancy. It is acquired by the passive part-
ner but is not transmitted to the active partner. Significantly, the 
MACS also showed that once a homosexual man becomes HIV-positive, 
progression to AIDS is further determined by the amount of passive 
anal intercourse sustained after "infection". This is contrary to all 
that is known about infectious diseases. Infection, not repeated in-
fections, causes disease. Indeed, the Royal Australasian College of 
Surgeons (RACS) considers HIV-positive surgeons to be "infectious" 
and that they "should not perform invasive procedures or operations", 
but "they may provide these services to patients who have the same 
infection".[114]

110. Goedert, J.J., Sarngadharan, M.G., Biggar, R.J. et al. (1984), 
"Determinants of retrovirus (HTLV-III) antibody and immunodeficiency 
conditions in homosexual men", Lancet 2:711-6.

111. Stevens, C.E., Taylor, P.E., Zang, E.A. et al. (1986), "Human T-
cell lymphotropic virus type III infection in a cohort of homosexual 
men in New York City", JAMA 255:2167-2172.

112. Caceres, C.F., van Griensven, G.J.P. (1994), "Male homosexual 
transmission of HIV-1", AIDS 8:1051-1061.

113. Kingsley, L.A., Kaslow, R., Rinaldo, C.R. et al. (1987), "Risk 
factors for seroconversion to human immunodeficiency virus among male 
homosexuals", Lancet i:345-348.

114. West, R.H., O'Connor, T.W., Penny, R. et al., "Policy Document: 
Infection Control in Surgery", Royal Australasian College of Sur-
geons, Melbourne, 1998.


Heterosexuals

The largest and best-conducted studies in heterosexuals, including 
the European Study Group,[115] showed that, for women, the only sex-
ual practice leading to an increased risk of becoming HIV-antibody-
positive is anal intercourse. The unidirectional transmission of 
"HIV" observed in OECD countries is supported by Nancy Padian's 10-
year study of heterosexual couples (1986; 1996). There were two parts 
to this study: one cross-sectional, the other prospective. In the 
cross-sectional study, "The constant per-contact infectivity for 
male-to-female transmission was estimated to be 0.0009 (1 in 1), 
[111]". The risk factors for the women were: (i) anal intercourse; 
(ii) having partners who acquired this infection through drug use 
(Padian says this means the women may also be IV drug users); (iii) 
the presence of STDs (antibodies to their causative agents may react 
in an "HIV" antibody test).[15],[20] Of the HIV-negative male part-
ners of 82 HIV-positive female cases, only two became HIV-positive - 
but under circumstances that Padian considered ambiguous. In the pro-
spective study, starting in 1990, 175 HIV-discordant couples were 
followed for approximately 282 couple-years. At entry to the study, 
one third used condoms consistently and, in the six months prior to 
their last follow-up visit, 26 per cent of couples consistently 
failed to use condoms. There were no seroconversions after entry, in-
cluding the 47 couples not using condoms consistently. Based on the 2 
in 86 men who became HIV-positive in the early study, the risk to a 
non-infected male from his HIV-positive female partner was reported 
to be in the order of 1 in 9,000 per contact. From this statistic one 
can calculate that, on average, a male would need to have 6,000 sex-
ual contacts with an infected female to achieve a 50 per cent chance 
of becoming HIV-positive. If sexual intercourse were to commence at 
age 20 and average three times weekly, this would occupy a life-
time.[57], [116]

15. Papadopulos-Eleopulos, E., Turner, V.F., Papadimitriou, J.M. 
(1993), "Is a positive Western blot proof of HIV infection?", 
Bio/Technology 11:696-707. 

20. Papadopulos-Eleopulos, E., Turner, V.F., Papadimitriou, J.M., 
Causer, D. (1997), "HIV antibodies: Further questions and a plea for 
clarification", Curr. Med. Res. Opinion 13:627-634.

57. Padian, N. and Pickering, J., "Female-to-male transmission of 
AIDS: a re-examination of the African sex ratio of cases", JAMA 
256:590.

115. European Study Group (1989), "Risk factors for male-to-female 
transmission of HIV", Brit. Med. J. 298:411-414.

116. Padian, N.S., Shiboski, S.C., Glass, S.O., Vittinghoff, E. 
(1997), "Heterosexual transmission of human immunodeficiency virus 
(HIV) in northern California: Results from a ten-year study", Am. J. 
Epidemiol. 146:350-357.


Female Prostitutes

The notion that HIV is a virus which "does not discriminate" is also 
markedly inconsistent with the data obtained from studies of female 
prostitutes. Even if by some unknown means a sexually transmitted in-
fectious agent found its way into the promiscuous portion of the gay 
male population in certain large cities in the United States in the 
late 1970s (as is widely accepted), and given the facts that prosti-
tutes are frequented by bisexual men and that, at the very earliest, 
"safe" sexual practices date from 1985, one would have expected 
HIV/AIDS to have spread rapidly through prostitutes and thence to the 
general community. However, the prevalence of "HIV" antibodies 
amongst prostitutes is almost entirely confined to those who are drug 
users. Virtually all other prostitutes have not been, and are not be-
coming, HIV-positive. In September 1985, 56 non-intravenous drug us-
ing (IVDU) prostitutes were tested "...in the rue Saint-Denis, the 
most notorious street in Paris for prostitution. More than a thousand 
prostitutes work in this area... These women, aged 18 [60], have sex-
ual intercourse 15 -25 times daily and do not routinely use protec-
tion." None was positive.[118] In Copenhagen, 101 non-IVDU prosti-
tutes, a quarter of whom "suspected that up to one fifth of their 
clients were homosexual or bisexual", were tested during August - Oc-
tober 1985. The median numbers of sexual encounters per week was 
twenty. None was positive.[118] In 1985, 132 prostitutes (and 55 non-
prostitutes) who attended a Sydney STD clinic were tested for HIV an-
tibodies. The average number of sexual partners (clients and lovers) 
in the previous month was 24.5. When an estimate was made to separate 
clients and lovers, the median number of sexual contacts per year 
rose from 175 to 450. The partners of only 14 prostitutes (11%) used 
condoms at all, and 49% of their partners used condoms in fewer than 
20% of encounters. No women were HIV-positive.[119] The same Austra-
lian clinic repeatedly tested an additional 491 prostitutes who at-
tended between 1986 and 1988. Of 231 out of the 491 prostitutes sur-
veyed, 19% "had bisexual non-paying partners and 21% had partners who 
injected drugs. Sixty-nine per cent always used condoms for vaginal 
intercourse with paying clients, but they were rarely used with non-
paying partners. Condoms were rarely used by those clients and/or 
partners for the 18% of prostitutes practising anal intercourse." No 
women were HIV-positive. At the time of this report, a decade into 
the AIDS era, the authors commented that "there has been no docu-
mented case of a female prostitute in Australia becoming infected 
with HIV through sexual intercourse". Yet, these investigators from 
the Sydney Sexual Health Centre concluded that "there are still many 
women working as prostitutes in Sydney who remain seriously at risk 
of HIV infection".[120] In Spain, of 519 non-IVDU prostitutes tested 
between May 1989 and December 1990, only 12 (2.3%) had a positive 
test, which was "only slightly higher than that reported five years 
ago in similar surveys". Some prostitutes had as many as 600 partners 
a month, and the development of a positive antibody test was directly 
related to the practice of anal intercourse. The authors also noted 
that "a more striking and disappointing finding was the low propor-
tion of prostitutes who used condoms at all times, despite the sev-
eral mass-media AIDS prevention campaigns that have been carried out 
in Spain".[121] Similar data from two Scottish studies,[122] the 1993 
European Working Group on HIV Infection in Female Prostitutes 
study,[123] and a 1994 report on 53,903 prostitutes working in the 
Philippines and tested between 1985 to 1992, confirm that non-IVDU 
prostitutes remain virtually devoid of HIV infection. For example, in 
the latter study, only 72 women (0.01%) were found to be HIV-
positive. In studies where there appears to be a high incidence of 
HIV amongst prostitutes, there are uncertainties that defy explana-
tion. For example, although "HIV has been present in the commercial 
sex work networks in the Philippines and Indonesia for almost as long 
as it has been in Thailand and Cambodia", the prevalence of HIV in 
the former is 0.13% and 0.02% respectively and 18.8% and 40% in the 
latter.[124] If these are accurate data, the discrepancy defies epi-
demiological explanation and has indeed baffled the experts, although 
the latter postulate "behavioural factors", such as one country's 
prostitutes and clients being considerably more or less sexually ac-
tive than another. However, one could also pose another question. 
What are the "HIV" antibody tests actually measuring? Be that as it 
may, since 5,674 (44%) and 4,360 (34%) of the 12,785 Cambodian "HIV 
and AIDS Case Reports" till 31 December 1997 are listed as "Unknown" 
in gender and age respectively,[125] data collection, at least by the 
World Health Organization in Cambodia, must be regarded as problem-
atic. 

118. Krogsgaard, K., Gluud, C., Pederson, C. et al. (1986), "Wide-
spread use of condoms and low prevalence of sexually transmitted dis-
eases in Danish non-drug-addict prostitutes", Brit. Med. J. 293:1473-
1474.

119. Philpot, C.R., Harcourt, C., Edwards, J., Grealis, A. (1988), 
"Human immunodeficiency virus and female prostitutes, Sydney 1985", 
Genitourinary Med. 64:193-7.

120. Philpot, C.R., Harcourt, C.L., Edwards, J.M. (1991), "A survey 
of female prostitutes at risk of HIV infection and other sexually 
transmissible diseases", Genitourinary Med. 67:384-8.

121. Pineda, J.A., Aguado, I., Rivero, A. et al. (1992), "HIV-1 in-
fection among non-intravenous drug user female prostitutes in Spain: 
No evidence of evolution to Pattern II", AIDS 6:1365-1369.

124. Anonymous (1998), "The HIV/AIDS/STD epidemics in Asia and the 
Pacific", Australian HIV Surveillance Report 14:1-8.

125. Samrith, C., "Official HIV and AIDS Case Report", World Health 
Organization, Phnom Penh, Cambodia, 1997. 

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